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HomeMy WebLinkAboutCertified Mail - OT General - 3/21/1996T First-Class Mail UNITED STATES POSTAL SERVICE Postage&Fees Paid USPS E405 Permit No.G-10 • Pur name, address, and ZIP Code in this box • I I � � I V ' I I o Mason County Dept, of Health Services I tQ Offic@ Of Water Quality 410 N. 4th - P. 0. Box 1666 [1@ Shelton, WA 98584-5001 rn I I i . I �• SENDER: v ■Complete items 1 and/or 2 for additional services. I also wish to receive the N ■Complete items 3,4a,and 41b. following services(for an N ■Print your name and address on the reverse of this form so that we can return this extra fee): card to you. d ■Attach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address d permit. Y ■Write'Return Receipt Requested'on the mailpiece below the article number. 2. El Restricted Delivery to ■The Return Receipt will show to whom the article was delivered and the date delivered. Consult postmaster for fee. a o •d 3.Article Addressed to: 4a. Icle Number m 556 437 qso °` E 4b.Service Type ❑ Registered Certified °C rn (n ❑ Express Mail ❑ Insured E ❑ Return Receipt for Merchandise ❑ COD 0 7. Date of Delivery � o z O O (k7 tick�tli� D 5. Received By: (Print Name) 8.Addressee's Address(Only if requesi'ed w and fee is paid) t 6.Signatu e: (Ad essee or Age T X � N PS Form 3811, December 1994 1 Domestic Return Receipt